The Association Between Body Size and Breast Cancer in Han Women in Northern and Eastern China

Oncologist. 2016 Nov;21(11):1362-1368. doi: 10.1634/theoncologist.2016-0147. Epub 2016 Aug 5.

Abstract

Introduction: Although obesity has been reported worldwide as a risk factor for breast cancer, there are still some inconsistencies regarding the association between obesity and breast cancer. Body mass index (BMI) is used most to assess the extent of obesity; however, the association of other body size characteristics, such as waist and hip circumference, with susceptibility to breast cancer in Chinese Han women needs to be better assessed.

Patients and methods: Female Chinese Han patients (N = 2,800) were recruited from 21 hospitals in northern and eastern China from April 2012 to April 2013 for a case-control study. The significant differences of factors related to body size between the breast-cancer case and control groups were determined by Student's t test and chi-square tests.

Results: Premenopausal women with breast cancer had higher BMI and larger waist and hip circumferences (p = 2 × 10-4, <1 × 10-6, and 2 × 10-5, respectively). However, these body-size factors were not associated with postmenopausal breast cancer (p = .45, 0.32, and 0.12, respectively). BMI between 28 and 30 kg/m2 or greater than 32 kg/m2 was related to breast cancer incidence in the overall study population and in premenopausal women but not in the postmenopausal group.

Conclusion: Obesity is significantly associated with breast cancer in Chinese Han premenopausal women but not in postmenopausal women. Thus, it is important to realize that weight control, as well as avoiding abdominal obesity, should be considered as one of the most effective methods of reducing breast cancer risk.

Implications for practice: To better understand the characteristics and risk factors for breast cancer in Han women in northern and eastern China, a case-control study of 2,800 Chinese Han women was conducted. Obesity was significantly associated with breast cancer in Chinese Han premenopausal women but not in postmenopausal women. Consequently, controlling body weight and avoiding abdominal obesity should be considered as one of the most effective methods of reducing breast cancer susceptibility. However, the diversity between this study's finding among Chinese Han women and other data previously reported among European and American populations still needs further investigation.

摘要

引言. 尽管肥胖在全球范围内都被报道为乳腺癌的危险因素, 但肥胖与乳腺癌之前的相关性仍然存在一些不一致的情况。身体质量指数(BMI)是最常用的肥胖程度评估指标, 但其他体型特征如腰围和臀围对中国汉族女性乳腺癌的易感性仍然需要进一步评估。

患者与方法. 2012年4月至2013年4月期间, 从华北和华东地区的21家医院招募中国汉族女性患者(N=2 800), 开展病例-对照研究。使用Student’s t检验和卡方检验分析乳腺癌病例及对照组之间与体型大小相关的因素差异。

结果. 绝经前乳腺癌女性的BMI、腰围及臀围值均较高(P值分别为2×10-4, <1×10-6和2×10-5)。但体型因素与绝经后乳腺癌无关(P值分别为0.45、0.32和0.12)。在总人群和绝经前女性中, BMI在28∼30 kg/m2或>32 kg/m2与乳腺癌发生率相关, 但在绝经后女性中与乳腺癌无关。

结论. 肥胖在中国汉族绝经前女性中与乳腺癌显著相关, 但在绝经后女性中无关。因此认识到体重控制和避免腹型肥胖非常重要, 应考虑将之作为降低乳腺癌风险最有效的方法之一。The Oncologist 2016;21:1362–1368

对临床实践的提示: 为更好地理解华北和华东汉族女性的乳腺癌特征及危险因素, 我们开展了一项纳入2 800例中国汉族女性的病例-对照研究。肥胖在中国汉族绝经前女性中与乳腺癌显著相关, 但在绝经后女性中与乳腺癌无关。因此, 应考虑将控制体重和避免腹型肥胖作为减少乳腺癌易感性的最有效措施之一。然而本研究在中国汉族女性中得到的结果与既往其他报告中欧洲和美国人群数据之间的差异仍然需要开展进一步研究。

Keywords: Body mass index; Breast cancer; Chinese Han population; Menopause.